The Lipid-Rich Plaque Study

NCT ID: NCT02033694

Last Updated: 2020-05-19

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

1563 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-02-28

Study Completion Date

2018-09-30

Brief Summary

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The purpose of this study is to enhance medical knowledge of the causes of future coronary problems. Many studies in patients who have already experienced a coronary problem point to the danger associated with plaques that are rich in cholesterol. This study determines if the near-infrared method of detection of these fatty plaques can predict future events. If dangerous plaques can be identified, there are many treatments already available that could be tested for their ability to prevent coronary events.

Detailed Description

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Conditions

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Coronary Artery Disease Atherosclerosis

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Participants With 2 Years Follow up

Participants with NIRS-IVUS imaging at baseline and assigned to follow up for Non-Index Culprit Lesion related Major Adverse Cardiac Events (NC-MACE) for 2 years

NIRS-IVUS Imaging (TVC Imaging System)

Intervention Type DEVICE

Diagnostic Imaging Catheter

Interventions

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NIRS-IVUS Imaging (TVC Imaging System)

Diagnostic Imaging Catheter

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Subjects presenting for coronary angiography in whom IVUS imaging is likely to be performed for clinical purposes.
* Greater than 18 years of age.
* Clinical presenting symptoms meeting one of the three criteria below:

1. Subjects presenting with an acute coronary syndrome (ACS) including at least one of the following:

1. Elevated cardiac biomarkers with CK-MB or troponin greater than upper limits of normal;
2. ST depression or ST elevation \>1mm in 2 or more contiguous leads in the absence of LVH, paced rhythm, BBB or early repolarization;
3. A stabilized patient 24 to 72 hours post STEMI;
2. Unstable angina pectoris;
3. Stable angina pectoris and/or a positive functional study with evidence of ischemia.


* At least one Suspected Index Culprit Lesion requiring imaging with IVUS and/or NIRS for clinical indications.
* At least two native epicardial coronary arteries (which may include the Suspected Index Culprit Artery) eligible for imaging with NIRS-IVUS.

IVUS/NIRS Imaging Inclusion Criterion

* A minimum of a total 50 mm of coronary artery not involved in a prior or Index Procedure PCI (including the 5mm borders on either edge of the site receiving PCI) must be scanned. This 50mm total length may include contributions from the Suspected Index Culprit Arteries and from Index Non-Culprit Arteries. This total length must include contributions from two or more native imaged arteries.

Exclusion Criteria

* Unstable patients (STEMI within the prior 24 hours; cardiogenic shock, hypotension needing inotropes, hypoxia needing intubation, and IABP) and patients that had a procedural complication (coronary dissection, perforation or a complication that would necessitate immediate-unplanned revascularization) during index PCI procedure.
* History of CABG or planned CABG within 6 months following NIRS-IVUS imaging.
* Patient has additional lesion(s) that needs a staged PCI.
* Subject life expectancy is less than 2 years at time of index catheterization.
* Subject with ejection fraction (EF) \<30%.
* Subject pacemaker dependent/paced rhythm.
* Subject pregnant and lactating.
* Any other factor that the investigator feels would put the patient at increased risk or otherwise make the patient unsuitable for participation in the protocol
* Patients undergoing performance of PCI in all three major vessels during the index PCI.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medstar Health Research Institute

OTHER

Sponsor Role collaborator

Infraredx

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ron Waksman, MD

Role: PRINCIPAL_INVESTIGATOR

MedStar Heart Institute

Locations

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University of California Los Angeles Medical Center

Los Angeles, California, United States

Site Status

Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status

JFK Medical Center

Atlantis, Florida, United States

Site Status

Delray Medical Center

Delray Beach, Florida, United States

Site Status

Palmetto General Hospital

Hialeah, Florida, United States

Site Status

Florida Hospital Orlando

Orlando, Florida, United States

Site Status

Palm Beach Gardens Medical Center

Palm Beach Gardens, Florida, United States

Site Status

Memorial Hospital West

Pembroke Pines, Florida, United States

Site Status

Emory Midtwon

Atlanta, Georgia, United States

Site Status

Emory University

Atlanta, Georgia, United States

Site Status

Alexian Brothers Heart and Vascular Institute

Elk Grove Village, Illinois, United States

Site Status

St. John's Springfield

Springfield, Illinois, United States

Site Status

Community Heart & Vascular

Indianapolis, Indiana, United States

Site Status

Methodist

Merrillville, Indiana, United States

Site Status

Central Baptist Hospital

Lexington, Kentucky, United States

Site Status

McLaren Bay Region

Bay City, Michigan, United States

Site Status

St. John's

Detroit, Michigan, United States

Site Status

McLaren-Macomb

Mount Clemens, Michigan, United States

Site Status

Crittenton Hospital

Rochester, Michigan, United States

Site Status

University of Minnesota Medical Center

Minneapolis, Minnesota, United States

Site Status

Columbia University

New York, New York, United States

Site Status

LIJ Health System

New York, New York, United States

Site Status

New York Presbyterian Hospital Cornell

New York, New York, United States

Site Status

Metrohealth

Cleveland, Ohio, United States

Site Status

Hillcrest Oklahoma Heart Institute

Tulsa, Oklahoma, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

University of Texas Medical Branch

Galveston, Texas, United States

Site Status

St. Luke's Episcopal Hospital

Houston, Texas, United States

Site Status

Heart Hospital Plano

Plano, Texas, United States

Site Status

Davis Hospital and Medical Center

Layton, Utah, United States

Site Status

Charleston Area Medical Center

Charleston, West Virginia, United States

Site Status

San Biovanni Hospital

Rome, , Italy

Site Status

Latvian Centre of Cardiology

Riga, , Latvia

Site Status

Academic Medical Center

Amsterdam, , Netherlands

Site Status

Radboud University Medical Centre

Nijmegen, , Netherlands

Site Status

Erasmus Medical Centre

Rotterdam, , Netherlands

Site Status

Maasstad Ziekenhuis

Rotterdam, , Netherlands

Site Status

SUSCCH, a.s.

Banská Bystrica, , Slovakia

Site Status

Golden Jubilee National Hospital

Clydebank, , United Kingdom

Site Status

University of Edinburgh

Edinburgh, , United Kingdom

Site Status

Royal Brompton Hospital

London, , United Kingdom

Site Status

Countries

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United States Italy Latvia Netherlands Slovakia United Kingdom

References

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Waksman R, Torguson R, Spad MA, Garcia-Garcia H, Ware J, Wang R, Madden S, Shah P, Muller J. The Lipid-Rich Plaque Study of vulnerable plaques and vulnerable patients: Study design and rationale. Am Heart J. 2017 Oct;192:98-104. doi: 10.1016/j.ahj.2017.02.010. Epub 2017 Feb 16.

Reference Type BACKGROUND
PMID: 28938968 (View on PubMed)

Waksman R, Di Mario C, Torguson R, Ali ZA, Singh V, Skinner WH, Artis AK, Cate TT, Powers E, Kim C, Regar E, Wong SC, Lewis S, Wykrzykowska J, Dube S, Kazziha S, van der Ent M, Shah P, Craig PE, Zou Q, Kolm P, Brewer HB, Garcia-Garcia HM; LRP Investigators. Identification of patients and plaques vulnerable to future coronary events with near-infrared spectroscopy intravascular ultrasound imaging: a prospective, cohort study. Lancet. 2019 Nov 2;394(10209):1629-1637. doi: 10.1016/S0140-6736(19)31794-5. Epub 2019 Sep 27.

Reference Type BACKGROUND
PMID: 31570255 (View on PubMed)

Torguson R, Mintz GS, Di Mario C, Ten Cate T, Ali ZA, Singh V, Skinner W, Zhang C, Shea C, Kuku KO, Garcia-Garcia HM, Waksman R. Disparities among Black and White patients in plaque burden and composition and long-term impact. Cardiovasc Revasc Med. 2023 Oct;55:28-32. doi: 10.1016/j.carrev.2023.04.023. Epub 2023 May 1.

Reference Type DERIVED
PMID: 37271594 (View on PubMed)

Case BC, Torguson R, Mintz GS, Di Mario C, Medranda GA, Zhang C, Shea C, Garcia-Garcia HM, Waksman R. Additive Effect of Multiple High-Risk Coronary Artery Segments on Patient Outcomes: LRP Study Sub-Analysis. Cardiovasc Revasc Med. 2023 Jan;46:38-43. doi: 10.1016/j.carrev.2022.08.008. Epub 2022 Aug 6.

Reference Type DERIVED
PMID: 36058829 (View on PubMed)

Torguson R, Mintz GS, Case BC, Di Mario C, Zhang C, Shea C, Garcia-Garcia HM, Waksman R. Correlation between lipidic content and arterial-wall plaque burden: A Lipid Rich Plaque study sub-analysis. Int J Cardiol. 2022 Nov 1;366:32-34. doi: 10.1016/j.ijcard.2022.07.024. Epub 2022 Jul 13.

Reference Type DERIVED
PMID: 35842005 (View on PubMed)

Case BC, Shea C, Torguson R, Zhang C, Yerasi C, Medranda GA, Kuku KO, Garcia-Garcia HM, Mintz GS, Waksman R. Impact of Baseline Imaging of Non-Culprit Coronary Lesions on Adverse Events: Insight From LRP Study. Cardiovasc Revasc Med. 2022 Jun;39:1-5. doi: 10.1016/j.carrev.2021.12.012. Epub 2021 Dec 13.

Reference Type DERIVED
PMID: 34972665 (View on PubMed)

Torguson R, Shlofmitz E, Mintz GS, Mario CD, Cate TT, Ali ZA, Singh V, Skinner W, Zhang C, Shea C, Garcia-Garcia HM, Waksman R. Frequency of Lipid-Rich Coronary Plaques in Stable Angina Pectoris versus Acute Coronary Syndrome (from the Lipid Rich Plaque Study). Am J Cardiol. 2021 Nov 1;158:1-5. doi: 10.1016/j.amjcard.2021.07.033. Epub 2021 Aug 28.

Reference Type DERIVED
PMID: 34465457 (View on PubMed)

Bambagioni G, Di Mario C, Torguson R, Demola P, Ali Z, Singh V, Skinner W, Artis A, Cate TT, Zhang C, Garcia-Garcia HM, Doros G, Mintz GS, Waksman R. Lipid-rich plaques detected by near-infrared spectroscopy predict coronary events irrespective of age: A Lipid Rich Plaque sub-study. Atherosclerosis. 2021 Oct;334:17-22. doi: 10.1016/j.atherosclerosis.2021.08.022. Epub 2021 Aug 14.

Reference Type DERIVED
PMID: 34455112 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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https://www.ncbi.nlm.nih.gov/pubmed/28938968

The Lipid-Rich Plaque Study of vulnerable plaques and vulnerable patients: Study design and rationale. Am Heart J. 2017

https://www.ncbi.nlm.nih.gov/pubmed/31570255

Identification of patients and plaques vulnerable to future coronary events with near-infrared spectroscopy intravascular ultrasound imaging: a prospective, cohort study. Lancet. 2019

Other Identifiers

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The LRP Study

Identifier Type: -

Identifier Source: org_study_id

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